March 2018 •
Volume 20 •
Issue 3
Providing Current Information on
Health Insurance Industry Issues and Legislation
Employers Embracing Cost Control Strategies
Best in class employers are increasingly turning to self-insurance and a variety of
other strategies in their ongoing efforts to attract and retain employees, increase
revenue and contain their operating costs. Leader employers are limiting plan
options, utilizing wellness programs, disease management and tighter PBM controls
to rein in costs and increase employee satisfaction.
other strategies in their ongoing efforts to attract and retain employees, increase
revenue and contain their operating costs. Leader employers are limiting plan
options, utilizing wellness programs, disease management and tighter PBM controls
to rein in costs and increase employee satisfaction.
Kidney Failure and Dialysis: What You Need To Know
More than 14 million Americans over the age of 20 have some level of chronic
kidney disease and the number is growing by 5% a year. More than 660,000 suffer
from End Stage Renal Disease (ESRD) or permanent kidney failure. Dialysis costs
for a single ESRD patient can run $600,000 a year or more. Prevention, chronic care
management and patient support are the keys to controlling kidney disease.
kidney disease and the number is growing by 5% a year. More than 660,000 suffer
from End Stage Renal Disease (ESRD) or permanent kidney failure. Dialysis costs
for a single ESRD patient can run $600,000 a year or more. Prevention, chronic care
management and patient support are the keys to controlling kidney disease.
Controlling End Stage Renal Disease (ESRD) Dialysis Costs
Dialysis treatments for ESRD patients are expensive, really expensive. They can run
$600,000, $700,000 or more a year, easy.
For qualifying ESRD patients Medicare becomes the secondary insurer after a
qualification period. Consequently, payors are required to pay only the Medicare rate
for these patients' treatments. (Most groups choose to pay a multiple of that rate.)
While some cost containment companies grab as much as 12% of the billed charge
while others take 10% or more of the savings, HHC Group charges only a low per
treatment fee. Our client pays less, sometimes tens of thousands of dollars less.
$600,000, $700,000 or more a year, easy.
For qualifying ESRD patients Medicare becomes the secondary insurer after a
qualification period. Consequently, payors are required to pay only the Medicare rate
for these patients' treatments. (Most groups choose to pay a multiple of that rate.)
While some cost containment companies grab as much as 12% of the billed charge
while others take 10% or more of the savings, HHC Group charges only a low per
treatment fee. Our client pays less, sometimes tens of thousands of dollars less.
Telehealth Comes of Age
96% of large employers now offer some level of telehealth benefits, up from
23% just 5 years ago. Once used primarily for treating episodic needs (flu, colds,
upper respiratory infections etc.), projections are that it will become a virtual
care delivery platform for a full spectrum of medical conditions from behavioral
health to chronic diseases. Importantly, Telehealth holds the potential to
significantly reduce the costs to diagnose and treat chronic conditions which
make up 84% of the U.S. healthcare spend.
23% just 5 years ago. Once used primarily for treating episodic needs (flu, colds,
upper respiratory infections etc.), projections are that it will become a virtual
care delivery platform for a full spectrum of medical conditions from behavioral
health to chronic diseases. Importantly, Telehealth holds the potential to
significantly reduce the costs to diagnose and treat chronic conditions which
make up 84% of the U.S. healthcare spend.
Three Star Preferred Provider Program Additions
|
Atlanta, GA 30348 Johnathan Kolakows Jackson, TN 38305 Altenheim Strongsville, OH 44136 OrthoIndy Hospital Greenwood, TN 46143 Platte Valley Medical Clinic Saratoga, WY 82331 |
Austin, TX 78741 Silver Falls Dermatology Salem, OR 97302 Beckley Appalachian Regional Hospital Beckly, WV 25801 Deng Family Medical Center, PC Midwest City, OK 73130 |
